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Last Name
|
_________________________________ |
First Name
|
________________________________ |
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Street Address
|
________________________________________________________________________ |
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|
City
|
___________________________________________ |
State
|
________ |
Zip Code
|
________ |
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Home Telephone
|
________________________________________________________________________ |
|
|
Parent or Guardian
|
________________________________________________________________________ |
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Day-Time Telephone
|
_______________________________________________________________________ |
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E-Mail Address
|
_________________________________________________________________________ |
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Camper's Age
|
_________________________ |
Height
|
________________________________ |
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|
School
|
_________________________________ |
Grade Completed
|
____________________ |
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|
Coach's Name
|
_________________________________________________________________________ |
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|